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Pharmacy Resources & Forms

Drug Lists

We strive to offer our members many convenient and affordable ways for members to purchase prescriptions and medications. Working with you, members can use the appropriate prescription drug lists below to make smart choices about the drugs they take and the amount they pay.

Medication Review Request Fax CoverUse this fax cover sheet if your authorization request was denied and you are requesting an appeal, or if you are requesting review for coverage of an excluded pharmacy product. Please note: This form is a cover sheet only. You are required to submit pertinent medical information that supports the pharmacy related request along with this fax cover form.